Functional outcome following total knee replacement using posterior cruciate retaining implants

Author(s): Dr. M Devendra, Dr. Shekar M and Dr. HS Chandrashekar

Abstract: Twenty-eight total knee replacement (TKR) surgeries were performed using cruciate retaining implants at Sanjay Gandhi institute of trauma and orthopedics from October 2016 to October 2018. All patients were evaluated pre-operatively & post-operatively with knee society clinical, functional score. Average pre-operative knee society clinical score was 47.1 & functional score was 34.32. Main indication for T.K.R was osteoarthritis. Follow up period ranged from 6 months to 2 years. 96.5% of our patients scored 80 points or better for a rating of excellent by knee society clinical, functional score system. The mean post-operative knee society clinical score was 91.6, knee society functional score was 89.28. 90% patients had little/no pain post operatively, whereas walking ability similarly improved & was unlimited in 85% of the patients postoperatively. Average alignment of prosthesis was 4.9 degrees valgus. No radiolucency’s about the tibial component &femoral component were found at the end of 2 years of follow up. No evidence of D.V.T /pulmonary embolism. Post-operative complications included knee stiffness in 2 post op cases, extensor lag in 2 cases, post-operative surgical site infection in 2 post-operative case and persistent fixed flexion and varus deformity in 1 case. 96.5% of the patients had excellent results (knee score of>80) 3.6% of the patients had good (knee score between 60 to 80) results. T.K.R provided pain relief, adequate stability, and measurable change in the range of motion in severely painful, refractory unstable knees. Total knee arthroplasty has in the past 4 decades revolutionized the treatment of primary osteoarthritic and secondary osteoarthritic knees. With these excellent results we conclude that cruciate retaining total knee arthroplasty provided measurable pain relief, adequate stability, remarkable range of motion in severely painful knees refractory to conservative management. If performed taking into consideration proper selection of patients, meticulous attention to surgical technique and asepsis, Intra-operative soft tissue balancing, correct alignment of prosthesis and postoperative rehabilitation of patients, cruciate retaining total knee replacement has yielded excellent results. By this we can conclude that cruciate retaining total knee replacement is an established effective surgery in the treatment of osteoarthritic knees.

DOI: https://doi.org/10.22271/ortho.2019.v5.i2i.61